Ebola panel calls for change : “From a world of non-accountability and non-assistance, to a world of accountability and coordination

The speakers who gathered at the Center for Strategic and International Studies on Dec. 2 described in detail the lapses at every phase and every level of action and inaction that followed the outbreak about two years ago of Ebola in West Africa. They recounted the role played by a “mediocre, dysfunctional and unaccountable” World Health Organization, but also of failures by nations around the world to live up to agreements to build their health systems, and by others to acknowledge and respond to those gaps between goals and reality. But the primary purpose of their discussion was to urge that with memory still fresh of what happened and what didn’t happen after reports of the outbreak began to surface in the early months of 2014, that governments and agencies begin to undertake necessary and comprehensive reforms to global public health approaches now. Now, already, is too late, they noted, adding that the world remains currently unready for the next, inevitable infectious disease crisis.

The speakers included members of a panel assembled by Harvard’s Global Health Institute and the London School of Hygiene and Tropical Medicine that, the week before, had released a report on the global response to Ebola documenting the weaknesses the crisis had highlighted.

Those weaknesses surfaced, as the report described, in the countries where the outbreak took hold, where staffing, technology and expertise all were inadequate to note that an epidemic was spreading — gaps that had gone ignored by donor countries. More weaknesses showed when even after the outbreak posed a clear threat, affected countries had little motivation to report what was happening, and strong reasons not to, and when the reasons for that reluctance were confirmed — while aid came slowly but trade and travel restrictions came fast, with further debilitating effects. And, even as the world began to respond, failures to plan and communicate plans, to engage communities, to account for funds, to coordinate efforts and share knowledge illustrated a nearly universal lack of preparedness.

The panel had released 10 recommendations with its report the week before, covering prevention, response, research and governance to address future outbreaks. They included new rules, new organizational entities, new funding models and new approaches to research.

“We can’t be complacent with change around the margins,” said J. Stephen Morrison of CSIS, a member of the panel, also warning that “modest, internal reforms” will leave false confidence and continued vulnerability to health threats worldwide.

And while talk during the discussion of these recommendations frequently cited and returned to themes of politics, negligence, and incompetence at the World Health Organization, the responsibility for the impacts of WHO’s failings is broader, speakers noted.

Needed also, Dr. Peter Piot, also a member of the panel noted, is “a broader coalition than the G7” with planning that includes input from all affected regions and communities.

“This was, in the end, the success of a community based health response,” former White House Ebola Response Coordinator Ron Klain said. “We should never lose sight of that.”